title: Costs of diabetes and its complications in Poland.
abstract: OBJECTIVE
  Diabetes mellitus (DM) is a major health problem with severe complications and a significant impact on quality of life. It constitutes an enormous burden of disease due to high prevalence, severe co-morbidities and high costs for society. This study is the first comprehensive study on the direct and indirect costs of DM (type 1 and type 2) and associated complications in Poland.
  
  
  METHODS
  In order to estimate the direct medical costs of DM and its complications, including the costs of medical consultation, hospitalisation, rehabilitation, drugs and medical equipment, data from the National Health Fund were used. Indirect costs on loss of productivity due to diabetes and its complications were based on data obtained from the ZUS (Social Insurance Institution) and from GUS (Poland's Central Statistical Office). Attributable risk methodology was used to assess the burden of DM complications.
  
  
  RESULTS
  A continuous increase of the direct costs of diabetes has been observed since the year 2005. In the analysed time period (2005-2009) the direct costs of medical services for both types of DM doubled. DM is a cause of significant sickness absence and incapacity for work and therefore is associated with a growing productivity decline in Poland. The highest direct costs and indirect costs are associated with treatment of diabetes-related complications. Direct costs of hospital complication treatment were EUR 332 million, which exceeded by more than five times the direct costs of hospital treatment of diabetes per se, which in the same year amounted to EUR 58.5 million. The indirect costs of diabetes-related complications were higher by 41% compared with indirect costs related to DM itself. Total costs of health care services for DM and its complications amounted to EUR 654 million, which constitutes a 2.8% of total health care costs in Poland. Total DM cost in Poland in 2009 amounted EURO 1.5 billion.
  
  
  CONCLUSIONS
  DM is causing a growing economic burden on the health care system and on Polish society in terms of health care and productivity losses. Most of the total cost of diabetes are indirect costs caused by productivity losses. Both direct and indirect costs are driven by the cost of diabetes complications.
authors.affiliation: Koźminski University, 57/59 Jagiellońska St., 03-301, Warsaw, Poland, jlesniowska@kozminski.edu.pl.
authors.forename: Joanna
authors.initials: J
authors.lastname: Leśniowska
authors.forename: Agata
authors.initials: A
authors.lastname: Schubert
authors.forename: Michał
authors.initials: M
authors.lastname: Wojna
authors.forename: Iwona
authors.initials: I
authors.lastname: Skrzekowska-Baran
authors.forename: Marta
authors.initials: M
authors.lastname: Fedyna
mesh_terms: D017281:Cost of Illness; D048909:Diabetes Complications / Q000191:economics* / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000191:economics* / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000191:economics / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000191:economics / Q000453:epidemiology; D058065:Diabetic Cardiomyopathies / Q000191:economics / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000191:economics / Q000453:epidemiology; D016527:Drug Costs / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D011044:Poland / Q000453:epidemiology